Anal adenocarcinoma: case report, literature review and comparative survival analysis

IntroductionAnal adenocarcinoma is a rare malignancy with a poor prognosis.MethodsWe present a case of rare anal adenocarcinoma in a patient with normal screening colonoscopy. Using the Surveillance, Epidemiology and End Result database between 2000 and 2016, we performed survival analysis among individuals>20 years old comparing anal and rectal cancers.ResultsSurvival analysis showed that anal adenocarcinoma is associated with worse outcomes compared with rectal adenocarcinoma and anal squamous cell carcinoma.DiscussionThis case and survival data illustrate the importance of prompt investigation of symptoms irrespective of colorectal cancer screening status with careful attention to examination of the anal area.

Effectiveness of 5-Fluorouracil 5% Cream in Perianal Condylomata Accuminata Treatment: A Case Report

Background: Condylomata accuminata is a sexually transmitted disease, appeared as verrucous or cauliflower-like papules or warts in the anogenital. It is caused by human papillomavirus (HPV), mostly type 6 and 11. The ideal therapy should be simple, inexpensive, effective, does not cause side effects, and can be used by the patient himself. Purpose: To assess the effectiveness of 5-Fluorouracil (5-FU) 5% cream therapy for perianal condylomata accuminata treatment. Case: A 24-year-old male presented with a chief complaint of warts around the anal area that multiplied in the past 3 weeks. The acetowhite test was positive. The patient was diagnosed with condylomata accuminata perianal. The patient received 5-FU 5% cream, applied 3 times a week to the lesions for 5 weeks. After 5 weeks, no new warts were found. Discussion: 5-FU 5% cream is a therapeutic option for perianal wart lesions that easily applied, inexpensive, effective, does not cause side effects, and can be used by the patient himself. It is well known as an antimetabolite with a cytotoxic effect that occurs through a mechanism of disruption in the normal synthesis and function of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). The treatment with 5-FU 5% cream 3 times a week for 5 weeks provided good results with no side effects were reported. Conclusion: The application of 5-FU 5% cream was a modality of self-application treatment that effective for perianal condylomata accuminata.

Sacral Nerve Stimulation Lead Migration through the Sciatic Foramen, Successfully Repositioned

Introduction: SNS (Sacral Nerve Stimulation) has become an established minimally invasive procedure for urinary and faecal incontinence. Minor complications related to the procedure are common; include pain, infection or migration. We present a case of a tined lead migration through the sciatic foramen. Case Report: A 72-year-old woman with faecal incontinence, who did not respond to dietary of medical treatment, underwent a sacral nerve stimulation test. Under fluoroscopic vision a tined lead was placed in S3 foramen, with an adequate motor and sensory response. In the 7th postoperative day, she reported no improvement and she referred sensory response in the thigh and leg. Radiography showed migration of the electrode through the sciatic foramen. The repositioning of the same electrode was possible with a gentle traction of the lead. Correct placement of the lead was confirmed radiologically, and the patient showed motor and sensory response in the anal area. The patient improved Wexner score from 18/20 to 4/20. Conclusion: Migration of the tined lead should be considered if loss of response in found. Repositioning of the same lead is possible in selected patients, without the need of removal of the device.

A new genus and species of damsel-dragonfly from the Middle Jurassic of Inner Mongolia (Odonata: Campterophlebiidae)

The Campterophlebiidae is the largest family of fossil damsel-dragonflies, containing more than 60 species described from Lower Jurassic–Lower Cretaceous strata of Europe and Asia. This group is especially diverse in the Middle–Late Jurassic strata in Inner Mongolia, northeastern China, with some very large species (Zhang et al., 2006, 2008, 2013; Nel et al., 2007, 2008, 2009; Petrulevičius et al., 2011; Li et al., 2013; Zhang et al., 2013; Zheng et al., 2016, 2017). Thus it is surprising that we found a new representative of these damsel-dragonflies, belonging to a group of genera characterized by a very particular shape of the forewing cubito-anal area. This fossil has a unique shape of the forewing median vein, allowing its attribution to a new genus and species. It increases our knowledge about the palaeobiodiversity of this impressive group of Odonata.

The second genus of the ‘libelluloid’ family Araripephlebiidae (Odonata, Clavilabiata)

The Lower Cretaceous Crato Formation is a well-known Konservat Lagerstätte with a very rich entomofauna. The Odonata are especially very diverse and extensively studied (Bechly, 1998, 2000, 2007, 2010; Nel et al., 1998; Bechly et al., 2001; Bechly & Ueda, 2002) with representatives of all the extant anisopteran main subgroups. This fauna is especially interesting because it comprises some of the oldest and most ‘basal’ groups of the highly diverse extant ‘libelluloid’ dragonflies, or Clavilabiata Bechly, 1996. Among these, the monospecific family Araripephlebiidae Bechly, 1998 is remarkable in the highly specialized hind wing cubito-anal area that contains a curious supplementary longitudinal vein more or less parallel to AA and CuA, unique among the Odonata. Nevertheless, this family remained rather poorly known by three described specimens, only females.

Juvenile Hyaline Fibromatosis Management With a Diode Laser: A Rare Case Report

Juvenile hyaline fibromatosis (JHF) is an unknown hereditary disorder with variable penetrance. The characterizations of this disease consist of different signs and symptoms such as multiple tumorous (tumor-like) muco-cutaneous proliferation, gingival hypertrophy, perianal lesions, articular contractures, and osteolytic lesions. A 3-year-old girl with numerous painless nodular masses on her gingival, ear and anal areas is presented in this case report. Based on characteristic histological features, the diagnosis of JHF was made. The patient underwent surgery following general anesthesia and the above areas were surgically operated with appropriate laser parameters, and the patient was able to eat and wash away after a day and was discharged with an antibiotic prescription after one day in the hospital and returned to normal after a week. The recurrence occurred in other areas a year later, especially in the cheek, the ears and the anal area. Therefore, this rare case is presented with recurrence.

A new lizard species of the genus Darevskia Arribas, 1997 from Southern Armenia

A new species of rock lizards of the genus Darevskia Arribas, 1997 – Darevskia aghasyani sp. nov. is described from Urts Ridge in Southern Armenia. This species is characterized by a combination of the following characters: small size L – 49–54 mm, L. cd – 107, Sq – 52–56, Ventr – 26–27, G – 24, P. g. – 32–34, P. fm. – 18–20; it is painted in brownish-beige tones from above; the belly is whitish in both sexes, males in the anal area have yellow with ochre femoral pores; bluish spots appear on the edge of the outer ventral shields at the middle of trunk through one shield; on the sides of the trunk (chest area) there are two blue spots in males and one in females; rostral is separated from frontonasal by nasal shields and it does not touch the nostril; upper postocular is twice wider than upper temporal shield; posterior temporal shields are not pronounced, or slightly pronounced; in front of central temporal (Massetericum), there is one enlarged temporal shield; along the throat from ear to ear fold there are 32-34 scales; two large preanal shields present in front of the anal shield. A comparison of Darevskia aghasyani sp. nov. with other species of the genus from Armenia and representatives of “raddei” complex from neighboring regions of Turkey and Iran (Darevskia dahli (Darevsky, 1957), D. unisexualis (Darevsky, 1966), D. raddei (Boettger, 1892), D. raddei vanensis (Eiselt et al., 1993), D. nairensis (Darevsky, 1967), and D. defilippii (Camerano, 1877)) is given. Conservation status of taxa assessed as CR B2ac(iv) "CRITICALLY ENDANGERED".

A large cockroach from the mesosaur-bearingKonservat-Lagerstätte(Mangrullo Formation), Late Paleozoic of Uruguay

Barona arcuata, n.gen et n.sp., a left forewing of a relatively large cockroach of the Order Blattaria, is described from mesosaur-bearing lagoonal shales of the Mangrullo Formation (north-eastern Uruguay). While most of the insect remains recovered from the Mangrullo Formation come from sandy limestones, associated to scarce isolated mesosaur bones and pygocephalomorph crustaceans, the cockroach wing here described was found in the overlaying green to brownish, gray and dark black shales associated to intercalated bentonites and evaporitic gypsum crystals.Barona arcuatashares some features with typical Late Carboniferous taxa such as its general venation pattern and outline of the wing, four main and powerful veins arising close together from near the base of the wing, Sc simple forked, pectinate, reaching the costal border through a long fork, R and M bifurcating and terminating in the wing margin above and below the apex respectively, short and narrow CuA, and the presence of a broad interspace between CuP and AA. Cross venation seems to be absent or it was not preserved. Some characters might relateBarona arcuatato the Late Carboniferous-Early Permian Neothroblattinidae such as the presence of sigmoidal veins in the anal area, a condition not found in any of the remaining representatives of the Palaeozoic Blattaria. Intriguingly, the Uruguayan blattarian also presents a strong similarity withQilianiblatta namurensisZhang, Schneider & Hong, 2012 from the Westphalian of China, clearly a smaller taxon that is also difficult to relate to any of the preexistent families. The apparent plesiomorphic venation pattern of the new species which is reminiscent of that present in the oldest known blattarians, is in agreement with a Permo-Carboniferous (Gzhelian-Asselian) age for the Mangrullo Formation also supported by the presence of a macrofloral assemblage dominated by arborescent lepidondendrids and other lycopsids and the pygocephalid-like morphology of the pygocephalomorph crustaceans from the same levels.

Giant Condyloma Acuminatum in a Woman with AIDS

Objective: To describe a case of Giant Condyloma Acuminatum with aspect of HIV and some concerns about the CD4. Result: We describe 2 cases, the first case is a giant Condyloma in HIV patient and the second case is a giant Condyloma in pregnant woman. The patient in the first case was a 40-year-old woman with AIDS (CD4 is 290) who was undergoing anti-retroviral therapy. She was found to have a giant condyloma acuminatum of the vulva. Electrocautery excision was performed, and afterwards the quality of life has improved significantly. The second case patient is a 30-year-old G4P3A0 woman with a giant condyloma acuminatum. She was 30 weeks pregnant with a single fetus. On the external genitalia there was a giant condyloma mass on the vulva extending towards the peri-anal area, obstructing the introitus. The electrocautery excision was performed. She was discharged from the hospital on the second day in good condition. She had a spontaneous delivery after reaching full term. Conclusion: Although the giant Condyloma Acuminatum is combined with HIV, but it’s not as difficult as imagined because the tumor’s base is not wide, but shaped like inverted mushroom and it is not necessary to do local flap reconstruction. [Indones J Obstet Gynecol 2012; 36-4: 206-10] Keywords: electrocautery excision, giant condyloma acuminatum, surgery in AIDS